- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,737.80 / $10,715.19
| Facility | | $1,096.48 | $1,737.80 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $10,232.93
| Facility | | $6,456.54 | $7,585.78 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,549.93 / $11,481.54 / $15,488.17
| Facility | 50 | $9,549.93 | $11,481.54 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $3,801.89 / $11,748.98
| Facility | | $398.11 | $3,801.89 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $39.81 / $39.81 / $39.81
| Facility | AS | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $562.34 / $6,309.57
| Facility | | $251.19 | $562.34 | $6,309.57 |